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Shorter Regimen of Radiotherapy Safe for Soft Tissue Sarcoma

Findings with preoperative radiotherapy administered to dose of 42.75 Gy in 15 fractions for three weeks

By Elana Gotkine HealthDay Reporter

THURSDAY, Nov. 17, 2022 (HealthDay News) — For adults with nonmetastatic soft tissue sarcomas of the extremities or superficial trunk, a moderately hypofractionated, shorter regimen of radiotherapy is safe, according to a study published online Nov. 4 in The Lancet Oncology.

B. Ashleigh Guadagnolo, M.D., from the MD Anderson Cancer Center in Houston, and colleagues examined the safety of a moderately hypofractionated, shorter regimen of radiotherapy in a phase 2 trial involving adults with nonmetastatic soft tissue sarcomas of the extremities or superficial trunk and an Eastern Cooperative Oncology Group performance status of 0 to 3. Preoperative radiotherapy was administered to a dose of 42.75 Gy in 15 fractions of 2.85 Gy/day for three weeks in 120 patients.

The stopping rule computation did not indicate that the trial should be stopped early for lack of safety at any time. The researchers found that 31 percent of the patients developed a major wound complication at a median of 37 days after surgery. None of the patients had acute radiation toxicity (during radiotherapy or within four weeks after radiotherapy) of grade 3 or worse or an on-treatment serious adverse event. Late radiation toxicity (at least six months after surgery) of grade 3 or worse occurred in four of 115 patients: two femur fractures, one lymphedema, and one skin ulceration. No treatment-related deaths occurred.

“Although data are still maturing, this preoperative radiotherapy regimen offers a reasonable alternative to conventional fractionation, especially if it facilitates care at a high-volume sarcoma center or alleviates resource constraints that might interfere with the completion of five weeks of radiotherapy,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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